Clinical and pathological observations in India / by J. Fayrer.

  • Fayrer, Sir Joseph, 1824-1907.
Date:
1873
Catalogue details

Licence: Public Domain Mark

Credit: Clinical and pathological observations in India / by J. Fayrer. Source: Wellcome Collection.

Provider: This material has been provided by London School of Hygiene & Tropical Medicine Library & Archives Service. The original may be consulted at London School of Hygiene & Tropical Medicine Library & Archives Service.

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    TIlQ' urine was regularly drawn off; it remained clear, but was very watery; sp. gr. I'OIO ; neutral; neither excess of phospLiates nor mucus, neitlier albumen nor sugar. There was persistent partial priapism. Autopsi/.—The body was that of a vigorous muscular man. Viscera were healthy, except that the lungs were hypostatically congested, and the tubes full of mucus. All the other organs, whether thoracic or abdominal, were healthy. On examining the spinal column, it was ascertained that in the violent back- ward wrench, the third intervertebral cartilage had been torn across, or rather torn away from the upper surface of the body of the fourth cervical vertebra. The laminae of the third cervical vertebra were broken, and depressed upon the cord. On removing the medulla spinalis and its covering there was no apparent injury; but on laying open the theca a small spot of coagulated blood was found corresponding to the fractured laminae, and just above it the cord had been compressed and softened—practically cut in two. This was very evident, for on pouring a gentle stream of water on the cord, it washed out the softened nerve-substance, leaving a deep groove, as though a cord had been tightly tied round it. This injury was exactly beneath the depressed por- tion of the laminae, and must have been caused by their edges. Remarks,—This case is interesting both in a physiological and pathological point of view. The instances, I believe, are very rare in which men have survived such accidents more than a few hours. In this case the patient lived twelve days after the injury. It is impossible to conceive anything nearer to instant death than this man must have been on receiving the injuiy. The spinal cord was compressed, physiologically severed, just below the origin of the fourth cervical nerve, as the thii-d ver- tebra, with its intervertebral cartilage, was torn from the upper surface of the fourth. The phrenic nerve must then have been seriously compromised, as its third origin from the fifth cervical